The Strategy for our Veterans - Taking the Strategy Forward in Scotland
Abstract: The Strategy for our Veterans was published in November 2018. It sought to build on the work by organisations across the public, private and charitable sectors to support and empower veterans, by setting clear goals for the next 10 years to provide appropriate support for our current veterans and the veterans of the future. The aims were to ensure that every veteran would feel even more valued, supported and empowered. This builds on the work that the Scottish Government was already undertaking to support the Armed Forces and veterans community, as set out previously in Our Commitments (2012) and Renewing Our Commitments (2016), and through our more recent annual updates to the Scottish Parliament. Veterans are assets to our society and my ambition remains to make Scotland the destination of choice for Service leavers and their families, offering high living standards, great job prospects and a society that respects and values their contribution. The launch of the Strategy provided a timely opportunity for us to take stock nationally about how we measure up to those aims currently and in the future. Since its publication last year, we have been consulting extensively across Scotland about how to take the Strategy’s aims forward.
Abstract: Context: In response to the opioid crisis, federal guidelines were implemented, including the Veterans Health Administration's (VA) Opioid Safety Initiative in 2013. The impact of policies on patients near the end of life is unknown. Objective: Examine temporal trends in opioid prescribing, pain, and opioid overdoses among Veterans near the end of life. Methods: Retrospective, time series analysis of VA decedents between October 2009 and September 2018 whose next-of-kin participated in VA's Bereaved Family Survey (BFS). Using multivariate regression to adjust for sociodemographic and clinical covariates, we examined temporal trends in outpatient opioid prescribing, uncontrolled pain based on BFS report, and opioid overdose-related hospitalizations, in the last month of life, overall and by clinical diagnosis (cancer versus non-cancer). Results: Among 79,409 decedents, mean daily outpatient opioid dose in morphine milligram equivalents in the last month of life decreased from 4.6 mg in 2010 to 2.1 mg in 2018 (adjusted change -0.20 mg/year; P